Private Health Information Statement - Combined policy

Silver Plus Assure Hospital $750 Excess and Value Extras

RT Health - a division of The Hospitals Contribution Fund

Monthly Premium

$278.65 #

(before any rebate, loading or discount)

Covers only one person

Available in NSW & ACT

# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading or an insurer discount. Check with your insurer for details.

Hospital cover

This policy exempts you from the Medicare Levy Surcharge.

This policy provides accident cover and benefits for travel or accommodation (outside of hospital) - check with your insurer for details.

This policy includes cover for

Hospital Cover Legend
Back, neck and spineEye (not cataracts)Miscarriage and termination of pregnancy
BloodGastrointestinal endoscopyPain management
Bone, joint and muscleGynaecologyPain management with device
Brain and nervous systemHeart and vascular systemPalliative care
Breast surgery (medically necessary)Hernia and appendixPlastic and reconstructive surgery (medically necessary)
CataractsImplantation of hearing devicesPodiatric surgery (provided by a registered podiatric surgeon – limited benefits)
Chemotherapy, radiotherapy and immunotherapy for cancerInsulin pumpsRehabilitation
Dental surgeryJoint reconstructionsSkin
Diabetes management (excluding insulin pumps)Joint replacementsSleep studies
Dialysis for chronic kidney failureKidney and bladderTonsils, adenoids and grommets
Digestive systemLung and chestHospital psychiatric services
Ear, nose and throatMale reproductive system

This policy does not include cover for

Hospital Cover Legend
Assisted reproductive servicesPregnancy and birthWeight loss surgery

The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.

Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.

The following payments may also apply for hospital admissions

Excess: You will have to pay an excess of $750 per admission. This is limited to a maximum of $750 per year.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 2 months for all other treatments

Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product.

The Medical Costs Finder lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

$100 cap for day admissions. No excess for dependants under the age of 22.

For further information about this policy see

https://rthealthfund.com.au/understanding-your-cover/#HospitalCoverGuides

General Treatment Cover

This health insurer does not operate a preferred provider scheme.

This policy includes General treatment (Extras) cover for

General treatment legend
Note, for items marked with an asterisk *: 100% back on a range of no-gap services through our More for program, and no-gap network providers, subject to your cover, waiting periods and annual & membership limits. Find out more: https://www.rthealth.com.au/health-services/find-a-dental-clinic and https://www.rthealth.com.au/health-services/find-an-optical-provider.
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental*2$500 per policyPeriodic oral examination - $30.00
Scale & clean - $57.00
Fluoride treatment - $37.00
Surgical tooth extraction - $152.00
Optical*2$200 per policySingle vision lenses & frames - 100% of charge
Multi-focal lenses & frames - 100% of charge
Non PBS pharmaceuticals2$300 per policyPer eligible prescription - $35.00
Physiotherapy2$350 per policyInitial visit - $40.00
Subsequent visit - $35.00
Chiropractic2$300 per policy
(combined limit for chiropractic & osteopathy)
Initial visit - $37.00
Subsequent visit - $30.00
Acupuncture2$300 per policyInitial visit - $31.00
Subsequent visit - $26.00
Remedial massage2$200 per policyInitial visit - $30.00
Subsequent visit - $30.00
Blood glucose monitors12$300 per policy
(combined limit for blood glucose monitors & other services - Sub-limits apply)
Per monitor - 80% of charge
Dietetics/dietary advice2$300 per policyInitial visit - $35.00
Subsequent visit - $35.00
Eye therapy (orthoptics)2$300 per policyInitial visit - $30.00
Subsequent visit - $25.00
Occupational therapy2$300 per policyInitial visit - $38.00
Subsequent visit - $36.00
Osteopathy2Combined limit - see ChiropracticInitial visit - $39.00
Subsequent visit - $31.00
Vaccinations0$150 per policyPer service - $50.00
RT Health members pay no gap on a range of popular dental and optical services through HCF Dental or Optical Centres and the More for provider network. Health aids include blood pressure monitors, CPAP machines, tens machines, wheelchairs, wigs (conditions apply). Annual, membership, service and sub limits apply.

This policy does not include General treatment (Extras) cover for

General treatment legend
EndodonticOrthodonticOther treatments - check with your insurer
Hearing aidsPodiatry
Major dentalPsychology

For further information about this policy see

https://rthealthfund.com.au/understanding-your-cover/#HospitalCoverGuides

Ambulance cover

In NSW & ACT this policy provides:

Emergency: with a waiting period of 1 day, limited to $5,000 per person per year.

Call-out fees:  will be paid for each attendance, including emergency treatment without transport to hospital.

Other features of this ambulance cover

Unlimited cover for emergency ambulance attendance and transportation, and medically necessary, non-emergency ambulance transportation. The service must be provided by a state government operated, authorised, or approved ambulance scheme. Cover applies anywhere in Australia.

For further information about this policy see

https://rthealthfund.com.au/understanding-your-cover/#HospitalCoverGuides

Disclaimer

The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.

Covered

For information on what is covered under each category, see https://www.privatehealth.gov.au/categories

Restricted

Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.

Not Covered

These categories are not covered by this policy.